Mostly cheerful, sometimes snarky commentary on life science research and its broader impacts

For a while, I’ve been meaning to write about what an incredible change medical school has been, but I struggle to find words for the overwhelming gratitude I feel for it daily. It’s probably the best thing that ever happened to me.

It’s also hard to write about this without showing contempt of the many wonderful aspects of grad student life generally and the lab I work in specifically. But after being introduced to a field that places primary value on relationships and caring service for people and communities, I can’t see myself continuing my career in a field that is guided by the singular goal of individual achievement – defined by outcompeting your peers – any more than I can see myself becoming an Olympic athlete.

Despite being in the most supportive research environment I could imagine, I found the competitiveness of academic science soul-destroying, and didn’t fully realize the extent of it until this year. From talking to scientist colleagues in other fields, it seems that cancer research is particularly known for this. I still find it puzzling, given that nearly all the people I’ve worked with have been very collegial and collaborative and willing to share their expertise. But I don’t really want to talk about how this plays out for other people because those aren’t my stories to tell. I want to talk about the effect it had on me.

Having a publication accepted or advancing through the selection cycles of a scholarship competition felt really, really good. Maybe too good. Kind of addictive. I derived a good portion of my sense of self-worth by how I ranked against other applicants – not by how I treated people or based on how useful my work was likely to be to anyone except my own career. I also got a sinking feeling when people I perceived as rivals experienced similar success. I knew something was wrong when I realized I was envious even of my friends. These aren’t things I’m proud to admit, but they’re real and not altogether unanticipated consequences of the system of incentives set up for scientists today.

I was also getting really tired of the siloed thinking that so often permeates highly specialized fields, and of hearing that so many injustices staring us in the face “aren’t our problem” and having the conversation end there. While people have argued that scientists aren’t valued enough, the billions of dollars in research funding we receive, with almost no strings attached, testifies to the political clout we wield. And we don’t hesitate to use it to our own benefit, but we could do so much more. I would argue the least biomedical researchers can do is acknowledge the limitations of our own work and use the influence we have to amplify voices that are preferentially unheard (for example, those calling for dismantling systems of oppression as a way to support flourishing population health). Dr. Ruha Benjamin has some brilliant thoughts on how this might be achieved.

Last summer I attended a conference talk where a highly influential scientist in my field suggested that at least some of us in the audience should spend the rest of our lives on highly technical investigations of a rare type of cancer where the researcher:patient ratio is already close to 1:1. I felt like I was on another planet. While writing this post, a friend (who, obvs, knows me well) sent along a very relevant quote from Charlie Chaplin’s film The Great Dictator, which is very reminiscent of the thoughts that were running through my head then:

“We have developed speed, but we have shut ourselves in. Machinery that gives abundance has left us in want. Our knowledge has made us cynical. Our cleverness, hard and unkind. We think too much and feel too little. More than machinery we need humanity. More than cleverness we need kindness and gentleness. Without these qualities, life will be violent and all will be lost….”

I’ve got a long way to finishing my PhD, and who knows how I’ll feel in the 7+ years it’ll take to finish med school. But for now, I can’t imagine anything more fulfilling than this description of family medicine by a particularly inspiring doctor who spoke to us a few weeks ago:

Dr. Carolyn Gotay of the UBC School of Population and Public Health delivered an impressive takedown of the “most cancers are simply bad luck” article published by Tomasetti and Vogelstein in Science early this year (which is among the most irritating examples of basic scientists overstepping their authority that I’ve encountered in recent memory. I’ve accepted that I will forever have a bone to pick with people who think we can completely understand the world by sequencing it.)

The essence is: just because you can prove that an increased probability of acquiring “random” mutations contributes to a higher rate of cancer in tissues that have higher rates of cell division doesn’t mean that these are the ONLY relevant factors, as the authors implied in the article. The phenomenon described in this study doesn’t in any way rule out the contribution of external factors (like pollution, obesity, inflammation, infection, and likely many others that have not yet been described), which would then be amplified in tissues that have more frequently dividing cells. But there is so little funding for research into the environmental causes of cancer, which are not readily elucidated by high-tech ‘omics approaches currently captivating the field, that it’s easy to get the impression they aren’t relevant at all.

One thing I’ve found lacking from nearly all critiques of the original Science article is that they let corporate polluters off the hook (the implication in the original article was that if most mutations are simply “bad luck”, why worry about pollution as a risk factor?) Instead they mostly draw attention to the “lifestyle choices” leading to cancer only Personal Responsibility™ can fix.

The publication and uncritical acceptance of studies like this one brings into focus the need to seriously rethink the overwhelming tendency towards studying cancer as a molecular disease, using molecular approaches, lest we risk missing the forest for the trees (or dots on a sequencing chip). The documentary, Pink Ribbons, Inc., presents some good suggestions on where to start.

Much to the dismay of one of my more judgemental outdoor purist friends, I have joined a gym. I have also started running at a measurable frequency. Both of these activities utilize time I could be spending doing all kinds of paid and unpaid, meaningful and utterly devoid of meaning, stimulating and soul-destroying work. Meanwhile, my own health is on a definite downward trajectory, as I turn to high-calorie, dopamine-inducing foods for the energy I need to make it through the day, while my clothes burst at the seams (sometimes literally), my heart probably struggling to pump blood to my increasingly fried brain.

Going out for a run feels like a big f-you to anyone (read: everyone) who expects trainees in the biomedical sciences to sacrifice their own health in the name of an enterprise that shows them, by and large, no love. Every step forward, slow and clumsy as it may be, is in its essence giving the middle finger to the culture of overwork in my field, the culture of letting career aspirations override physical and mental well-being, and it’s deliciously gratifying.

For the past year or so, maybe more, I have been admonishing myself nearly every day for waking up too late (my perceived ideal wake up time being 6-7am), even though I manage to get to work at a reasonable time (~9am) most days, barring exceptional circumstances, or if I have to come in early for a big experiment. My brain has internalized the dogma of “productive people wake up early so in order to be productive I must do the same”, whereas my body has been utterly non-compliant.

I used to be an early morning person throughout my teenage and early adult years, but apparently am really not anymore. Whatever amount of sleep I get, I find that waking up an hour early reduces my productivity by an amount >> 1h if I have to do any creative or intellectual work that day. I feel irritable and sleep-deprived even if I got enough sleep (8h or more). There is just no benefit to doing this on an elective basis.

So, instead of starting every day with a sense of failure, I am officially striking Resolution #6 (get to work by 8am every day) from my list, given that it only succeeded in making me feel miserable, while negatively impacting my productivity on the rare days when it was adhered to. Making decent progress on the other resolutions, though, except #9 (piano) and #5 (pool/gym). Really struggling with the latter- it’s difficult to work out when you have no energy, but think I would have lots more energy if I got more (high-intensity) exercise. If anyone has suggestions on breaking this cycle, I’d love to hear them!

As the word on the street is that setting specific goals and having your friends hold you accountable for meeting them is key to keeping New Year’s Resolutions, I have decided to post mine, 2014 edition.

So here they are, in what I think is increasing order of difficulty/decreasing likelihood of success. What are yours?

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10. Actually set up Christmas decorations this year

9. Practice playing piano for 1h, 3x per week

8. Dedicate at least one weekend half-day to PhD thesis only (no admin work or emails); preferably use some of this time to plan experiments for the coming week

7. Cut down on eating out; make at least 50% of meals at home

6. Get to work by 8am each day

5. Go to the pool/gym 2x per week

4. Read a book for 30 min, 3x per week

3. Limit non-work Internet time to 1h per day or less

2. Floss at least 3x per week

1. Spend less time being angry about issues I have no control over (related to #3) oh who am I even kidding

So, my first supervisory committee meeting came and went, and what a humbling experience it has been. I generally don’t shy away from scientific discussions – the more heated, the better. Nothing excites me more than a good round of intellectual sparring. But giving a formal presentation is like kryptonite to the part of my brain responsible for articulating thoughts. I have no innate public speaking skills, never practice talks as much as I should (or at all), and, unsurprisingly, consistently emerge as a bumbling, nervous mess. It turns out that talking about your research within the familiar environment of your own lab (even when everyone is constantly challenging your ideas), and presenting the same to a group of faculty members, are two almost completely unrelated experiences. I had made the naive assumption that comfort with the former would prepare me for the latter, with predictable consequences.

I think the actual content of my presentation was OK, but the delivery was kind of a disaster. Yet my committee members were nothing but supportive and encouraging. Their subtle cues were so powerful in making me feel at ease (as much as I was going to get), and their approach is definitely one I will strive to emulate in the future. I also got very useful feedback from my advisor after the meeting – she emphasized that this is all part of the learning process that everyone goes through, and some learning only comes from experience and some of those experiences can be painful. It’s reassuring to know that mistakes made in the process of learning are not only forgiven, but expected.

All in all, it was a nerve-wracking and exhausting endeavour, but one that has provided a much-needed dose of humility. I look forward to many more such experiences that take me outside of my comfort zone and serve as reminders of all the learning that lies ahead.

“That something is everywhere and always amiss is part of the very stuff of creation. […] We could have planned things more mercifully, perhaps, but our plan would never get off the drawing board until we agreed to the very compromising terms that are the only ones that being offers.” – Annie Dillard

Today I had a chance to see a couple of old pals from a very special volunteer group, prompting several flashbacks to 2008, a pivotal year in my life highlighted by joining this group and meeting individuals who would become the most influential role models I’ve had to date – all while being graduate students in the midst of trying to figure out their own life and career paths. I remember being in awe of how knowledgeable, articulate, cool they were, and wanting to follow in their footsteps; now I’m a grad student myself and making goodness knows what impression on the younger generations. In any case, for me, being in the company of motivated, idealistic, passionate and inspiring colleagues is far and away the biggest perk of being a member of the university community. Academia is a slightly strange world and suffers from no shortage of systemic flaws, but on good days and to those granted the privilege of being part of it, it really is the land of milk and honey.